Research Unveils Differences in Prostate Cancer Screening Among General Practice Clinics

A recent study conducted by the University of Exeter has revealed significant disparities among GP practices regarding their likelihood of diagnosing prostate cancer through a blood test. The investigation aimed to determine the percentage of patients whose prostate cancer was identified using a prostate-specific antigen (PSA) test despite not exhibiting any symptoms.

The research, published in the British Journal of General Practice and funded by Cancer Research UK, indicates that one in five men with prostate cancer in England is diagnosed via PSA testing when they have no signs. This finding suggests fewer diagnoses through screening than previously anticipated.

PSA testing remains the sole available test for diagnosing prostate cancer in the United Kingdom, where it has become the most prevalent form of cancer, affecting over 55,000 new patients annually. While PSA tests are frequently employed when men exhibit urinary symptoms, opinions differ on whether they should be used without any signs.

The UK National Screening Committee advises against implementing a national screening program for PSA testing due to inconclusive evidence regarding its benefits. Some prostate cancers may progress without causing harm throughout a man’s life; thus, detecting these through screening could lead to unnecessary treatment with potential side effects like erectile dysfunction and urinary incontinence.

Men aged 50 and above can request the test from their GP after making an informed decision about the associated risks and benefits. The new study uncovered substantial variations between GP practices across England concerning the proportion of men diagnosed through PSA testing without symptoms, with no clear explanation for this disparity. It also found that men from deprived areas are less likely to undergo testing but more prone to developing late-stage prostate cancer.

Professor Gary Abel, leading the research at the University of Exeter, expressed surprise at the extensive variation observed between practices: “The ongoing ambiguity surrounding prostate cancer screening in the UK is evident. Men from disadvantaged backgrounds are at a higher risk for advanced-stage disease and less likely to be examined. We need a more consistent approach to testing men without symptoms to address this imbalance.”

The study, conducted by researchers from the Universities of Exeter, Manchester, Newcastle, and University College London, analyzed over 9,800 prostate cancer records from England’s 2018 National Cancer Diagnosis Audit. The audit involved GPs revisiting patient records after a diagnosis to record symptoms and tests administered.

Lead author Dr. Sam Merriel emphasized the role of GP referrals in prostate cancer diagnosis: “PSA blood testing is the sole available method for this purpose, albeit with known limitations. Variations in local, regional, and national guidance mean it’s up to individual GPs to decide which patients should be tested, how frequently, and what PSA threshold warrants urgent referral.

The study highlights inconsistencies contributing to variations in detecting prostate cancer through PSA testing among asymptomatic men. Although the possibility of a cancer diagnosis can be anxiety-inducing, evidence suggests that PSA screening may cause more harm than good for symptom-free individuals.

Cancer Research UK’s director of evidence and implementation, Naser Turabi, stated: “The National Screening Committee continuously reviews the latest research and currently does not recommend prostate cancer screening. We are committed to finding better ways to detect and treat this disease by supporting further research that can help save lives.”